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Nerve Disorders of the Foot and Ankle
Similar to well known nerve disorders in the hands, such as carpal tunnel syndrome, nerve disorders that affect the foot and ankle occur in patients for reasons ranging from stress to genetics. Nerve disorders of the foot should be addressed right away because they may be immobilizing in serious cases. Two of the most common nerve disorders of the foot and ankle are Interdigital Neuroma and Tarsal Tunnel Syndrome.
Interdigital Neuroma is caused by localized inflammation of one of the nerves that controls toe sensitivity in the frontal area of the foot. This inflammation is generally only found in the second or third interspace, and any other symptoms similar to Neuroma on other digits should be checked against other disorders. Symptoms include chronic burning or tingling sensations between the affected toes which can, at times, migrate to the toes themselves. This pain is often increased by walking, running, or by wearing shoes that compress the toes, such as high heels. A doctor should be consulted if this pain is chronic and if the symptoms get worse.
Typical examinations to determine the presence of Neuroma include radiographs, MRIs, and even bone scans of the affected area. Bone scans are only required if degeneration of bone is suspected, however. Surgery is often not required to alleviate the symptoms of Neuroma, and in many cases functional orthotics can be used to alleviate the stress of constant weight on the affected toes. Surgery is recommended for those patients that suffer from symptoms for 6 months or more, so reporting symptoms early can increase the rate of non-surgical recovery.
Tarsal Tunnel Syndrome, a condition that is less common than Interdigital Neuroma, is similar to Carpal Tunnel Syndrome in that it is caused by a compression of the nerve caused by any number of factors (mostly associated with excess pronation). Typically seen in those that have either flatfeet or valgus heel positions, Tarsal Tunnel Syndrome has patients complaining of moderate to severe ankle pain that starts along the bottom of the foot and often proceeds to the calf. Some more extreme cases occur with partial numbness and even atrophy of the foot and surrounding muscles.
If there is a good chance that someone has Tarsal Tunnel Syndrome, an EMG test is often used to diagnose the condition. If the diagnosis is positive, an MRI can be used to identify the compression of the nerve. Treatment with NSAIDS, functional orthotics, and rest off of the feet is often prescribed, but again, long standing symptoms require surgery, as do exacerbated symptoms caused by lesions present between nerves.
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Foot Therapy for Sports Injuries
Whether in practice or in the game, athletes put their bodies through great stress. Some sports tax and demand more from the body than others, but every sport has an element of inorganic movement or unnatural motion. For ample, in softball, a pitcher winds up and flings her body with incredible amounts of dexterity in order to get the most ideal velocity out of her pitches. This motion, incredibly taxing on the body, can cause serious injury.
With regards to athletic injuries, one of the most common issues resides in the feet. Whether a damaging fracture that leaves athletes sidelined or simple turf toe, foot injuries can be very frustrating and painful. Regardless of sport, athletes require use of their feet in some fashion. This is why foot therapy is so vital in order to get athletes back on the right track and training again to return to the field.
No matter the injury, the best way to speed up the recovery period is to receive physical therapy. Physical therapy as a founded practice has proven to work for millions of people. Physical therapists are trained specifically to help people return to proper form from any injury, having gone through years of schooling in order to do so.
During physical therapy, you will go through organized training in order to get back into form. Sometimes training can be quite difficult, especially in the beginning when there is more pain and the foot feels awkward. To alleviate that you will do basic twisting and stretching exercises in order to get flexibility and foot mobility back up. The therapist will also massage the injured area in order to activate and relax muscles. Over time you will eventually move up to strengthening exercises, designed specifically so that activation of the injured area is ensured.
Foot therapy for sports is a modern science miracle. Devoid of fancy chemicals and terminology, physical therapy is an evidence based practice that is well designed as any other. Due to huge advancements and knowledge of muscles and joints, physical therapists can turn catastrophic injuries around so athletes can return to the game once more.
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Blisters on the Feet
Blisters are a common ailment of people who wear shoes that are either too tight or rubbed up against their feet in the wrong way while wearing them. In order to better understand how they are formed and what treatment should be used for them, you have to start with the basics of what a blister actually is.
A blister on the foot, or any other part of the body for that matter, is a small pocket that is filled with fluid. It usually forms on the upper layer of the skin because these layers are loose enough to allow a blister to form. The most common fluid in a blister is just a clear, watery like fluid that should not cause any concern. However, blisters can fill up with blood if they are deep enough and even pus if they have become infected with bacteria.
Blisters almost always form on the feet due to shoes rubbing up against the foot, where the friction causes blisters. These can occur after you have walked for a long period of time for example, or when your shoes simply do not fit you properly. They also form faster and easier if your feet are moist, so keeping them dry and clean is a preventative step you can take to avoid getting blisters.
Preventing infection should be the number one concern when treating blisters, as well as alleviating the pain they can cause. Using a band aid to cover up the blister will help it heal and prevent bacteria from entering it. New skin will form under the blister and eventually cause it to pop, or you can take a pin and try to pop it yourself.
If the blister is filled with pus or blood, seeking treatment from a doctor is ideal. Antibiotics might need to be taken in order to completely eliminate the bacteria inside the blister, and that needs to be prescribed by a doctor.
However, one of the best ways to treat blisters is to prevent them all together. Keeping your feet dry and making sure that your shoes fit properly are just two of the steps you can take to prevent blisters. Shoes that are too tight or shoes that are too loose and allow your feet to slide in them will cause blisters. Applying a band aid to an area you think might get a blister before one pops up is another way you can prevent them.
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Causes, Symptoms, and Treatment for a Broken Foot
One out of ten broken bones is reported in the feet. When an object crushes, bends, or stretches the bone beyond acceptable ranges, bones break. A break in the foot is either a fracture or a straight break.
The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked hard and with great force. Heel breaks almost always are as a result of an improper landing from great height. Twists or sprains are the other two frequent occurrences, and as with all usual breaks, result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time—repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break—stress fractures occur from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.
Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high—as are a few other particular bones. As the severity of the broken foot increases, symptoms like blueness, numbness, misshaping of the foot, cuts, or deformiti es will crop up and indicate the requirements of a medical professional with access to an x-ray facility.
Prior to this severe point however, reduction of pain and swelling at home should be the first priority. Elevate and stabilize the foot, don’t move it. Immobilization of the foot is the next priority, so jury-rigging a homemade splint is acceptable. Keep in mind while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and alleviate pain symptoms.
When dealing with a medical center, the patient should note that the treatment will be different from what is stated dependent on which foot bone has been fractured and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bone or bones.
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Effect of High-Heels on the Feet
For hundreds of years, women have been wearing various kinds of high-heels for mostly aesthetic reasons. Women who wear high-heels appear to be taller and to have longer and thinner legs, and the wearer’s gait and posture changes. Though high-heels have had an association with femininity and have kept them popular over the years, there are definite health problems caused by wearing them too frequently.
The motion of the ankle joints is limited when heels are worn. The ankle joint is very important to the body when it comes to walking. Because of their location, these joints have a great deal of weight put on them. Thus, it is very important to keep them as healthy as possible. The Achilles tendon is the main tendon in the ankle. Wearing high-heels too often, studies have shown, can cause the calf muscle and Achilles tendon to shorten and stiffen, which can cause problems when shoes without heels are worn.
By putting a great deal of pressure on the ball of the foot, by forcing the toes into a small toe box, high-heels can cause or may worsen many foot problems, such as corns, hammertoe, bunions, Morton’s neuroma and plantar fasciitis.
Not only does wearing very high-heels regularly have negative effects on the feet, the rest of the body can suffer as well. The knees, one of the most important joints in the entire body, can be affected by wearing high-heels. High-heels causes the knees to stay bent all the time. Also, it can cause them to bend slightly inward as well. Doctors believe that women can suffer from osteoarthritis later in life because of constantly walking like this. By limiting the natural motion of the foot during walking, high-heels also cause an increased in stress on the knees.
Similarly, the back may also be affected by high-heels because it causes the back to go out of alignment. If high-heels are worn constantly, the spine’s ability to absorb shock can cause continued back pain. They can compress the vertebrae of the lower back, and can overuse the back muscles.
However, this is not to say that high-heels can never be worn. If worn occasionally, they will not cause serious problems. They should not be worn every day in order to avoid the long-term physical health problems of the feet, knees, ankles, and back like mentioned above.
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Diabetic Foot Care
Millions of people are affected with diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of, or else the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.
It is very important to always wash and dry the feet thoroughly, especially in between the toes, when diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain. You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the die. Additionally, well-fitting socks are highly recommended.
A diabetic’s physician should always monitor their blood levels to test how well the blood sugars are being controlled during the p. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with neuropathy of a diabetic patient. It is also advised to see a podiatrist if experiencing any feet conditions. Toe nails may also need to be taken care of by a podiatrist, since some patients may cut too deep around the cuticles, causing infection.
A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. When using tools to remove calluses, use caution, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to call a podiatrist.
On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound gets too bad to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can cause in diabetics that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.
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Sport Related Foot And Ankle Injuries
Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sport are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly they can lead to permanent disability.
Plantar fasciitis is a painful condition. It is inflammation of the plantar fascia, the thick fibrous band of tissue running from the heel to the base of the toes. There are several effective treatments for this ailment. Doctors often proscribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery usually in that order. The most effective treatment for plantar fasciitis is orthotics, such as foot supports. Surgery is occasionally used as a last resort.
The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount and intensity of stress placed on it. It can either be treated non-surgically with rest, ice or anti-inflammatory medication or surgery may be required. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.
Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require arthroscopic or reconstructive surgery followed by rehabilitation
Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled, licensed medical professional.
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Getting the Right Shoe Size: To Keep Your Feet Happy
People are constantly wearing the wrong fitting shoes. Though it isn’t hard, picking the right shoes does require keeping a few things in mind.
Shoe stores have rulers, so you can get an exact measurement of your feet. Always measure your feet with shoes on, because measuring just your foot will give you a shoe size that is 1-2 inches too small for picking the right size shoe.
To ensure that your toes won’t be cramped, make sure there is wiggle room. Approximately one inch should be between your toes and the tip of your shoe. It is easy to tell if your shoes are too tight, because you will start to experience pain, blisters, and swelling.
Additionally, do not always assume your shoe size will be the same at every store. Manufacturers sometimes run differently, and your shoe size will vary. Make sure the stores your purchase from have return policies, incase there is a problem.
Rather than shoe shopping in the morning, it is advised to shop for shoes later in the day, since your feet are swelled. If shoes are purchased in the morning, they may not be as snug as they should be. Furthermore, not all two feet are the same size; therefore, accommodations may be necessary.
An overall big concern in buying shoes is making sure they are comfortable and supportive. There is not such thing as a shoe being ‘broken in’. If they are uncomfortable at the store, they likely will always be uncomfortable.
Since we do a lot of walking, it is important that we pick the right shoes. Our feel will only benefit from this, and we will be happier and healthier because of it.
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Systemic Diseases of the Foot
There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis.
In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid, crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.
Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.
There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.
Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.
All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.
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Everything You Need to Know About Gout
Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the metatarsal phalangeal joint on the big toe; though it has been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.
The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers and the children of parents who suffer gout will have a two in ten chance of developing the condition as well.
This form of arthritis, again noted as being particularly painful, is the leftover uric acid crystallizing in the blood stream and travel to the space between joints where they rub causing agonizing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Tertiary side effects may include fatigue and fever though reports of these effects are very rare. Some patients have reported that, as the temperature drops (when you sleep for instance) the pain may intensify.
Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms, however there are defined tests that can be performed. A blood test to detect elevated levels of uric acid is often used as well as the use of an x-ray to diagnose visible and chronic gout.
Treatment for gout simply means eliminating symptoms; non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation, however, diet, lifestyle changes, and preventative drugs are necessary to fully combat the most severe cases.
Those that lead a sedentary lifestyle are at a higher risk for gout. Any amount of exercise decreases probability of repeat encounters with the condition. Also, staying away from, or reducing drastically, consumption of red meat, sea food, and fructose-sweetened drinks reduces the likelihood of chronic gout as well.
As for diet, beyond what has already been mentioned, ingesting Vitamin C, coffee, and particular dairy products help on the preventative maintenance side of healthy living. While new drugs are out on the market that inhibit the body’s production of uric acid-producing enzymes, reducing or eliminating as much as possible your overall levels of uric acid will ensure you lead a gout-free life.
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